Cancer can take my boob, my lymph nodes, my tummy fat and my dignity. But I decided early on in my treatment that if it wanted to take away my chances of becoming a mother it was in for a tough fight.
That’s why three weeks after getting engaged to my boyfriend of 13 years we weren’t discussing catering or venues. We weren’t even discussing mastectomies. We were discussing embryos.
Jackie Scully, 32, offers her tips to any women concerned about their fertility
The fertility question is an interesting one when you’ve been diagnosed with breast cancer. Talking about life after cancer before you’ve even started the fight may seem strange. But if having babies is all part of the next chapter then it’s a question worth asking.
Cancer likes to take control. Fertility preservation is your way of taking some of that control back. While it’s not possible for all patients, if someone gives you the chance to get an egg in the freezer, grab it with both hands. I knew when I was diagnosed on 17 January that I didn’t want to be sitting in a chair watching chemo drugs enter my bloodstream and thinking I had the chance and I let it go.
Yes it’s a hassle. Yes it involves self-injecting and – depending on your hormone receptor status – maybe some anti-cancer drugs like Letrozole thrown in too. Yes, there are blood tests, internal scans (complete with jelly) and you do spend a lot of time with your skirt off (a change from being topless). And yes it’s a big deal often sandwiched between surgery and chemotherapy (two other big deals), and it can feel relentless. But ask me whether I’d do it again and I’d say: absolutely!
I can’t tell you whether your fertility experience will be similar, but I can tell you the injecting does end, and whether it’s eggs or embryos you’re after you’ll be in great hands.
I found the science of fertility with its oocytes and talk of intracytoplasmic sperm injections far more mind-boggling than the oncology side, but I felt reassured that the specialists were doing everything they could to give my ovaries a good workout!
For me, from day one of my period the cycle took 15 days. It involved numerous consent forms and some Provera (to delay my period), followed by daily injections of Menopur (and Cetrotide too from day seven). All this was combined with some Letrozole to control the oestrogen levels. When the experts were happy my follicles were at a good size, I stopped the drugs and took one injection of Ovitrelle (a trigger injection taken at a specific time to stimulate the final maturation of eggs). Mine was 2am on Saturday night. Egg collection took place around 36 hours later. Then all I had to do was wait for a call to see how many embryos they managed to freeze.
I’m writing this the day after we found out we have seven embryos in the freezer. I hope we never have to use them, but it’s good to know they’re there. We were lucky and I want you to be lucky too. Whether you’re convinced or still a little scared, here are my top tips for getting through the most unromantic baby-making process ever!
12 fertility tips
1) Just ask: when it comes to fertility, timing is everything. Ask your breast care nurse as soon as you can and they should be able to refer you and include it as part of your treatment plan. I promised my family I wouldn’t do anything to delay my treatment or risk my health. I remember mentioning this to my surgeon on surgery planning day. He laughed and said: ‘Jackie if you think we’re going to let you do anything that would risk your recovery you’ve got another thing coming.’
2) You’ll feel better if you pick up the phone: having been weighed down by cancer leaflets, the whole science surrounding fertility can seem a bit daunting. You’re in charge of measuring the right dosage as prescribed, and blood tests will determine whether or not that dosage should change. I remember waiting one night for a call from the clinic to hear whether I should alter my dosage. No one called and I was left with the decision of what to inject. I opted for the same amount (fearful this might cause problems) but wished I’d called to remind them I needed an update. When there are eggs at stake the only foolish question is the one you don’t ask.
3) Get an overview of the treatment: if you’re thrown into fertility treatment you don’t really get time to prepare. I often didn’t know what was going to happen from one day to the next. All I knew was that my fridge and kitchen drawers were packed with syringes, an NHS cool bag and a sharps box. An overview at the start would have made all the difference. When you get your chart, ask your nurse to explain each stage so you get a sense of what happens when. The plan may change but at least you will come away happy there is a plan.
4) Embrace the internal scans – they are much nicer than a smear test: uncomfortable subject, yes, but worth tackling to put you at ease. When they said they’d like to scan me, I lifted my top thinking it would be a normal ultrasound. Let’s just say you can keep your top on but the knickers have to come off!
5) Don’t fear those needles: self-injecting sounds frightening but the needles are tiny, and once you get the hang of it you’ll be able to do it with your eyes shut (but please don’t!). The nurses can show you how, and the drug mixing bit is easy.
6) Read the instructions through to the end first: like all good cake recipes, you get the best results by reading through all the steps first.
7) Alternate injection sites: your thighs and tummy will love you. My friend also suggested you don’t take short cuts and try to inject through tights!
8) Be kind to yourself: sitting in the waiting room at the assisted conception unit I would often feel a bit like a fraud. We hadn’t tried to have children, so why should we deserve to be fast-tracked when other couples desperate for children have to wait in line? It was only when I was heading to hospital with my first box of Menopur that it hit me. I was just another woman trying her hardest to cling on to the hope of having a family. We don’t ask for cancer. We just have to be moved up the list because there is more than just the life of a baby on the line.
9) It’s OK to not be OK: one night I cried while preparing my injection. It wasn’t the needle but the fact I felt weary from the appointments, tests, cancer and babies – and the end wasn’t in sight. It may not be life-saving treatment but that doesn’t make it any less emotionally draining and tiring. It’s OK to just be the person you feel when you wake up in the morning. No one is judging.
10) Don’t worry about the egg collection procedure: one gown, one pair of foam slippers, one mesh cap, a quick sleep and you’re done. There is a bit of discomfort but if you’re doing this post surgery (I was post tummy tuck) you’ll be an anaesthetist’s dream!
11) Everyone needs a post-procedure treat: having been nil by mouth, all I was thinking about when they put me to sleep was the delicious raspberry doughnut waiting for me when I woke up.
12) It doesn’t have to end with the eggs: fertility back-up plans come in many forms, and I have just embarked on the second one. Zoladex is a hormone treatment injected as an implant to temporarily suppress your ovarian function. Views vary about its use, but having discussed it with my oncologist I had my first implant yesterday. As long as you don’t look at the needle you’ll be fine. Should I come through chemotherapy with my fertility intact I will never need to call assisted conception again.
If you’d told me as I was celebrating my engagement that I might be infertile by the time I eat my next mince pie, I would never have believed you. Now I know I’ve done everything in my power to keep the hope of being a parent alive.
We all deserve the chance to experience that first laugh, first step or first day at school. It’s a chance I hope you’ll take if time and health are on your side.
Find out more
If you’d like more information about fertility issues and breast cancer treatment (particularly the different options available to you) Breast Cancer Care produces a great booklet on fertility.
Jackie Scully is a 32-year-old publishing professional with stage 3 invasive lobular breast cancer. She is currently exploring the laughter, happiness and tears that can come from a breast cancer diagnosis on her uplifting blog Small boobs, big smiles.
Vita bloggers' views are their own and do not necessarily represent those of Breast Cancer Care or Vita magazine.